Clinical manifestations of dengue: what should you know?

Dengue is a mosquito-borne viral illness. A febrile episode may include chills, headache, marked muscle aches, joint pain, nausea, tiredness or a rash. Easy bruising, bleeding from the nose or gums, or blood in vomit or stool can be warning signs. Symptoms can change as the fever settles, so feeling cooler does not always mean the illness is over.

A clinician considers recent travel or residence, mosquito exposure, symptoms and examination findings. Blood tests may be used at an appropriate stage of illness. Other infections can look similar, so do not try to confirm dengue from symptoms alone.

Contact a GP promptly if dengue is possible, particularly after travel or residence in an area where it occurs. Rest and take frequent fluids if you can. Use only a fever or pain medicine that a clinician or pharmacist considers suitable for you; ask before using medicines that may increase bleeding risk. Avoid strenuous activity while unwell.

Keep a record of fever, fluid intake, urine output, vomiting, pain and any bleeding. Prevent mosquito bites while feverish by following local advice, since mosquitoes can acquire the virus from an infected person.

Seek urgent medical help for severe abdominal pain, repeated vomiting, bleeding, black stools, marked drowsiness, confusion, faintness, breathing difficulty, cold clammy skin or inability to drink. Children, pregnant people, older adults and people with significant medical conditions may need earlier review.

Ask whether dengue testing is appropriate, which pain or fever medicines are safe, how much fluid is suitable, what warning signs to monitor and when a repeat review is needed. Tell the clinician about travel dates, mosquito exposure and every medicine you use.